Context in Therapeutic Work with Young People

By Werner van der Westhuizen

Date Posted: 15 June 2013

Werner van der Westhuizen MA(SW), qualified as a social worker and he worked as a probation officer with children in trouble with the law before taking up position as village director at SOS Children’s Village Port Elizabeth, South Africa. He has an active interest in therapeutic work with children and families. He also operates a small private practice, and volunteers as a crisis counsellor for Lifeline.

Context in Therapeutic Work with Young People

by Werner van der Westhuizen

When working with young people we can think of context as something external, that is the physical environment and the way people are organised and interacting in the environment. We can also consider context as internal, the subjective representation we create in our minds of our external world. Both of these are valid ways of understanding context (and in fact there may be many more ways of conceptualizing context), and our interventions can therefore be designed to be “contextual” both in terms of being directed at the physical environment and interactions, or the young person’s internal world. The focus of this article is on our internal representations, the context of the world we create within our minds, and how the child care practitioner can utilise this understanding to respond effectively to the young people we work with.

As child care practitioners working in the life space of children and youth people, we are not only faced with creating environments and relationships that meet their needs and nurture their development, but also with responding to their behaviour which at times reflect their inner turmoil. When attempting to understand the behaviour of a young person, we often ask the question: “What was the context of the behaviour?” Most often, what follows is a description of the immediate environment and external events that preceded the “troublesome” behaviour. When the behaviour does not seem to fit into this context, we classify the behaviour as inappropriate, dysfunctional, irresponsible or any of a number of labels. But what if our understanding of the context is inaccurate or flawed in some way? What would the implications be for our response to the young person?

When we think of our work and interventions as contextual, we often think of the context as a pre-existing condition, so that our responses and interventions must fit within the context in order to make sense to us. This means that we accept the external context as reality, and then we respond by taking care that our responses must make sense within the existing frame. Often when an intervention does not match the context, it feels out of place and it does not carry the meaning that we intended it to carry. In a conversation, the essence of the communication – the central meaning and intention – is then lost in the process, and usually the communication channel itself is disrupted as rapport may be lost momentarily. If we are skilled enough to be aware of what is happening, we can recover from this momentary rupture in rapport and recapture it, usually by reframing what we said or explaining the intention. If sufficient rapport existed, this is usually effective and we can carry on where we left off.

If someone were to observe that in the middle of a rain storm a person runs into the street and dances around, they might consider the behaviour to be a little “crazy”, because it does not fit into the context of what people normally do during a rain storm. If however they knew that rain dancer had just won millions in the lottery, then the behaviour would not seem so silly, and could even be considered “normal” for someone who instantly became rich. It would be more acceptable and would match the context. Similarly, when young people’s behaviour does not make sense to us, it is usually because we are missing some background information, because we don’t have the complete picture. It is a commonly accepted principle in child and youth care work that all behaviour is purposeful and has meaning when its context is understood. While the context may not always be obvious to us, because part of the context is internal, and part is external. We can observe the physical environment, the movements of other people and events, but we cannot directly observe how the young person interprets the environment and represents it to himself internally. Even when we think we understand the context, we must remember that our understanding is nothing more that our own internal representation, the pictures, sounds and feelings we create in our minds through the process of filtering the information we receive through our own senses. This is mostly an unconscious process, since it takes place outside of our conscious awareness. This unconscious internal filtering process is also how most of our meaning-making takes place. We usually accept the meaning we have for our world since it feels to us as if it is automatically there, and we don’t have to consciously think about it. Of course we can modify the meaning we give to our external context by consciously evaluating our beliefs and thoughts, but that is another process.

Context is therefore never as real as we think it is. One can argue that there is no real, existing, objective context – and even if there were, how could we know it? There is only our interpretation of what we see, hear and feel, and the meaning we make of that. However, having been trained to be aware and sensitive about this, we can be open-minded enough to allow for all these inconsistencies so that we can develop rapport with the young person and respond in a meaningful way when we understand their context, because that is the only context of importance when we choose how to respond. It does not mean that the young person’s internal representation of context is correct or right, it only means that we must first understand and accept this internal world before we respond, because in the young person’s world his or her behaviour makes perfect sense, and fits completely into their context. It also does not mean that there is no external context, only that we can only know context subjectively and internally.

Sometimes, interventions aimed at changing behaviour are ineffective, because from the young person’s perspective changing the behaviour will not match the context as they experience it. If we can accept that all behaviour is purposeful, we can also accept that to the young person his behaviour makes sense in his context – even if he is not aware of how this happens. Therefore, in order to help a young person change his behaviour (assuming that a behaviour change is needed), we can also focus our interventions on the internal representation or internal context of the young person. In order to do this effectively, we must first understand the young person’s internal representation – the context from his perspective. The only way to gain this understanding is through interaction with the young person, in such a way that meaning can be shared and understood. Therefore, any intervention without a significant relationship and rapport with the young person ignores an important part of the bigger picture, and takes place with some of the context missing. If the young person’s internal context changes, then his behaviour is more likely to change in order to make sense within its “new context”. In this way we are working directly with context, working to understand it and change it, in order to indirectly change behaviours, beliefs, thoughts and feelings.

This understanding of context is also useful to us when we work with (what we understand to be) resistance to change. Resistance in the young people we work with can be understood as essentially a failure on the part of the practitioner to establish sufficient rapport to understand their world as they perceive it. This emphasises the centrality of the relationship as a significant factor in any change work with young people, but even more so, that is not only about the existence of a significant relationship, but also having rapport in the moment when the opportunity is there to suggest alternative ways of perceiving things. So when the practitioner works with context and not the behaviour per se, they are not asking the young person to change, so there can also be no resistance, because there is nothing to resist. In doing so we fully accept the young person for who he is and we seek to deeply understand his world, and then we use daily events and moments to introduce new ideas that may change the young person’s perceptions of his world, and ultimately his behaviour. However, for our interventions to be effective, they must be acceptable to the young person. One way of presenting our interventions to the young person in such a way that it might be acceptable, is to gift wrap the interventions with a metaphorical wrapping paper made from the young person’s own words, metaphors and the stuff that makes up his life.

One approach to intervention that is useful is having a sense of curiosity. Showing a genuine interest promotes rapport and also creates the opportunity to explore ideas with the young person. We can be curious about the young person’s experiences, and utilise the same curiosity to introduce challenges to his perceptions without being overt. In other words, we can present the young person with challenging ideas gift-wrapped in curiosity. For example, “You know how to get angry really quickly. It usually takes me a long time to do that. So I was wondering, how do you do that?” While the question appears innocent enough on the surface level, it actually directs the young person to search his internal world for information which he may not be consciously aware of. For example, he may be using negative self-talk, but not have been aware of it until now. If the question is delivered in such a way that it carries sufficient sincerity and curiosity, the young person is more likely to respond positively.

Young people often do not understand their own behaviour themselves. When we say that behaviour is purposeful, we do not mean that every child is consciously aware of the purpose of their actions. We know that their behaviour serves a deeper purpose, often meeting a basic need that has remained unfulfilled. So when we want to work with the internal context of young people, we must know that they may not be aware of how they represent external events internally to themselves. They may not – or often do not – understand that their world is their own subjective creation. They accept their external world as hard fact and external reality, concrete, physical and unchanging. Therefore our approach needs to be sensitive – we should be careful not to destabilise the only reality that the young person has available to him. When we create some doubt about the concrete nature of reality, we should be ready to offer a better way of understanding that it is more acceptable to the young person. Our approach must be cautious and sensitive, working at the young person’s own pace.

The purposeful use of humour is another intervention that has a strong potential to create a “contextual shift” with the young person (Digney, in Garfat, Fulcher & Digney, 2012). The purpose of introducing humour is never to humiliate or to trivialise something, because that will interrupt rapport and the connection will be lost. The purpose of introducing humour is to both change the internal state of the young person and to change his internal context. It is possible to take any serious situation and when humour is introduced in such a way that you really find something funny about it, even if you try, you can never quite get back the seriousness with the same intensity. It always seems to lose some of its impact once humour has been introduced in a way that is acceptable to us.

Humour changes how we perceive the world around us, and all this means is that we have changed our internal representation of the external world to incorporate an alternative way of perceiving things. It is very important that the humour has to be acceptable to the young person, because the moment that he can accept that there is something funny – he is seeing something he has not seen before, his understanding has changed and his internal context has changed. Even if he does not make any dramatic belief changes, the hard, objective reality has been shaken just enough to allow for the possibility of other options. The teachable moment presents itself, and it is up to us to seize the opportunity.

While there may be countless interventions and approaches that could be appropriate in responding to the needs of young people, their effectiveness relies greatly on the ability of each practitioner in developing a significant relationship with young people, within which moments of rapport may provide us with a glimpse into their personal context. It becomes then not so much a matter of responding to them, but rather joining with them in making sense of their world and broadening their range of perceptions and responses in their world.